Accreditation is a growing, worldwide Phenomenon (Braithwaite et al., 2006), yet the empirical and theoretical literature on accreditation is amazingly sparse. This proposed study is the first step towards a research agenda examining accreditation as an organizational intervention to improve the lives of those with psychiatric illness. The aims are to 1) build toward a theory of how accreditation can improve mental health service delivery models and 2) explore agencies'experience with the accreditation process. This study addresses the National Institute of Mental Health's (NIMH's) Division of Services and Intervention Research's high priority areas (NIMH, 2008a) as it will lead to research in developing, designing, and testing accreditation as an innovative service delivery intervention. This study also responds to key objectives of NIMH's new strategic plan regarding developing better interventions that incorporate the diverse needs and circumstances of those with mental illness (Strategy 3) and understanding the means by which mental health interventions are disseminated and implemented (Strategy 4.1) (NIMH, 2008b). Using multiple case study methods, this research proposal will identify the specific processes that can make accreditation a more effective tool for quality improvement. Multiple sources of evidence will be collected from several children's mental health agencies that have recently completed the Council on Accreditation (COA) process. Qualitative data from in-depth interviews and focus groups with informants will reveal what specific aspects of accreditation enhance and hinder quality. Quantitative survey data will characterize each agency in terms of their organizational context while also gaining a broader view on accreditation from all employees. A review of documents related to accreditation and limited observations of the agencies will supplement these data and be used for triangulation. These data will help build a theory of accreditation by generating testable hypotheses for more empirical research to move the field forward. Greater attention needs to be paid to accreditation since it is a critical leverage point for improving the quality of care. Both the Institute of Medicine (IOM, 2006) and the Surgeon General (U.S. Department of Health and Human Services, 1999) have cited accreditation as an organizational intervention with the potential to improve the quality of our nation's ailing mental health service system. Mental health organizations are investing thousands of dollars and a great deal of time into accreditation efforts, yet it is not known if or how it makes a difference in service quality. This research could unlock accreditation's public health impact and its potential to improve service delivery and outcomes for the millions served by accredited organizations.